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To the Editor:
I read with interest the trial by Bahra et al.1 on the treatment of acute cluster headache with oral zolmitriptan, in which they found a modest but significant difference between the treatment and placebo groups. I was surprised that the article contained only one sentence concerning treatment of acute cluster symptoms with high-flow oxygen, in which it was disparaged as “cumbersome and impractical.” This raises several points. 1) Although their study methods are not strictly comparable, the absolute benefit shown by Fogan2 in his randomized, placebo-controlled study was far greater than that shown by Bahra et al. for zolmitriptan, consistent with common clinical experience. 2) Is “cumbersome and impractical” worse than “extremely expensive”? Keeping an oxygen tank in the bedroom or office is neither cumbersome nor impractical. I practice in an area in which the …
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